Experimental Evaluation of Bretschneider's Solution for Myocardial Preservation in Cardiac Transplantation

Myocardial preservation by Bretschneider's solution (BR solution, Group I) with an intracellular like electrolyte and histidine buffer action was compared with EC-Bi solution (Group II) which has an extracellular like electrolyte and bicarbonate buffer action in the mongrel dogs. The PH and PCO2 of the effluent from the coronary sinus were maintained during myocardial ischemia for 3 hr but the lactate rose gradually in group I. The oxygen and lactate up-take ratio of the myocardium after re-perfusion was satisfactory and LV max dp/dt was also maintained at a high level in group I. Morphologically, myelin figure and mitochondrial deformation were more found in group II on electron microscopy. A donor heart preserved for 3 hr in cold BR solution was transplanted in the left thoracic cavity in four mongrel dogs by the technique of the heterotopic cardiac transplantation. Resuscitation of cardiac pulsation was smooth and maintenance of the systemic circulation after transplantation was possible in every case. From these findings, it might be concluded that myocardial preservation using cold BR solution was useful for cardiac transplantation

Roentgenographic Study of the Chest of the Aged: special reference to "senile lung" and the paraspinal line

The characteristics of the changes of "senile lung" and normal values of the width of the paraspinal shadows on the chest roentgenographs were studied among 235 subjects aged from 70 to 97 without frank chest diseases. The ratio of upper transverse diameter (at the level of posterior 6th rib) to lower transverse diameter (at the top of right hemidiaphragm) on the frontal radiographs was significantly higher over the age of 85 than under 84, only in the female subjects. However, a lack of differences could be found in males. Therefore, "senile lung" was considered to be characteristic of the aging process, only for women. The width of the paraspinal shadow over the age of 70 was estimated to be normal in up to 19.9mm, and the index divided by the distance of descending aorta was up to 0.61, obtained from the value of 99% confidence limits

A Case of Acquired Leucoderma, Associated with Hashimoto's Thyroiditis

A 67-year-old female diagnosed as Hashimoto's thyroiditis in company with acquired leucoderma was reported. She first noticed the enlarged thyroid at the age of 36, and thereafter leucoderma made its appearance 30 years later. Though a significant association between these two diseases has been found in the literature thus far and they are considered to be of autoimmune origin, their coexistence is not so common clinically. In spite of PUVA treatment, a benefit effect was not obtained completely

Pacemaker Inhibition During Cardioplegia in Open Heart Surgery

A 53-year-old patient underwent mitral valve replacement after implantation of permanent pacemaker. During cardioplegia in open heart surgery, we performed the inhibition of permanent pacemaker to obtain complete myocardial preservation and quiet heart, using stimulations of an external pulse generator. This procedure is considered available, when the patient who has had a permanent pacemaker undergoes open heart surgery more safely

Effect of Immunomodulatory Artificial Blood Exchange (IABX) on Guinea Pig-to-Rat Heart Xenografts

The aim of this study was to assess the effectiveness of pregraft immunomodulatory artificial blood exchange (IABX) in a guinea pig-to-rat xeno discordant heart transplantation, using an artificial blood (FC43 emulsion: The Green Cross, Japan) in exchange for a large volume of whole blood to remove humoral immune factors en bloc from the recipient rat. In the rats treated with IABX, rhythmic beating of the grafted heart was maintained for 2 hr, whereas the untreated heart beat lasted for only 15.2 ± 5.2 min (n=6). In the graft hearts treated with IABX, no pathologic changes such as multiple coronary thromboses due to hyperacute rejection (HAR) were observed. Humoral immune factors (natural-IgM titer, ACH50 and CH50 complement activities, platelet count, prothrombin time (PT), activated partial thromboplastin time (APTT) and fibrinogen serum concentration), which are thought to contribute to HAR, decreased significantly following the IABX treatment.　　 We conclude that IABX is an efficient method for prolonging the survival time of guinea pig heart xenografts by inhibiting thrombus formation in the xeno-graft heart. It was confirmed that IABX could remove recipient humoral immune factors en bloc.This study was supported by The Green Cross Co.,Ltd

Clinical Analysis of 110 Postoperative Deaths of the Patients with Permanent Implantable Pacemaker

During 14 years follow up of 754 patients received permanent cardiac pacemaker (PM) implantation, 110 cases have died. In this paper, the cause of death of them was clinically analyzed. The death to senility was most frequent, in 31 cases out of 110 deaths (28.2%), and then heart failure in 19 cases (17.3%), cerebrovascular disease in 16 cases (14.5%), sudden death in 14 cases (12.7%), malignancy in 7 cases (6.4%), acute myocardial infarction in 7 cases (6.4%), severe infectious disease in 4 cases (3.6%), unknown etiology in 4 cases (3.6%), renal failure and Disseminated Intravascular Coagulation Syndrome (DIC) in 2 cases (1.8%), respectively, suicide in one case (0.9%). Cause of death by underlying disease was rather characteristic. Senility was frequent in the patients with atrioventricular (A-V) block (38.5%), while cerebrovascular disease was highly observed in the patients with Sick Sinus Syndrome (SSS) (28.1%), and heart failure was highly observed in the patients with atrial fibrillation (46.2%). Senility was seen in 44.8% of the patients with coronary arteriosclerosis, cardiac death in 85. 7% of the patients with cardiomyopathy, and in 100.0% of the cases with valvular disease. The above mentioned fact suggests that cardiovascular check up is most important in postoperative follow up of the patients with PM. In old cases, senility and infection were major cause of death, so guidance concerning to dietary life and periodical health examination against wasting disease is important especially in this group. And, active care for heart failure is also more important in the patients with cardiomyopathy and valvular disease

Findings of Transesophageal Echocardiographic Images in Placing the Coronary Sinus Perfusion Catheter

In retrograde cardioplegia (RCP), some difficulty is occasionally encountered when inserting a catheter into the coronary sinus (CS). Although the usefulness of transesophageal echocardiography (TEE) for guiding the cannulation procedures has been previously reported by other authors, we have obtained additional findings by TEE monitoring of eleven patients during placement of the CS catheter. The diameter of the CS ranged from 5.5 to 10.7 mm, indicating that it was large enough for the CS catheter to be inserted and that the resistance at insertion was not due to narrow CS. The precise time for inserting the catheter, for which myocardial protection is delayed, ranged from 8 to 376 seconds, with an average of 98 seconds. Dislodgement of the catheter was found in two cases. In case of difficult cannulation, the catheter tip was found to be pushing the right atrial wall adjacent to the CS orifice or alternatively it entered the middle cardiac vein which had a common atrial orifice with the CS in this particular case. We found that the knowing the following technical problems helps appropriate monitoring: the catheter tip becomes unclear when it is not perpendicular to the ultrasonic beam, when surgeon's fingers are placed behind the heart, or when the blood is entirely exsanguinated. Finally we present the possibility of employing images of overflow out of CS during RCP infusion, detected by TEE, as an index of efficient perfusion at the interventricular septum

MEFV gene mutations in neuro-Behçet's disease and neuro-Sweet disease

ArticleAnnals of clinical and translational neurology. 6(12): 2595-2600 (2019)journal articl

脊椎椎弓根スクリュー誤挿入後,再挿入を行った際の引き抜き強度についての研究

Screw malposition, such as lateral wall breach or end-plate breach, is one of the main pitfalls of inserting pedicle screws. Methods: From 17 fresh spines 54 vertebrae were harvested. In each vertebra on one pedicle the screw was inserted correctly down the axis of the pedicle, while on the other pedicle the screw was inserted to breach the lateral wall or the end-plate. The 18 pedicle screws that breached the lateral wall were then removed and re-directed along the correct axis of the pedicle. The 18 pedicle screws that breached the end-plate were removed and re-directed along the correct axis of the pedicle. The 18 other pedicle screws that had breached the end-plate were not removed. The pullout force of pedicle screws was measured. Results: 1) The mean pullout strength for the re-directed screws following lateral wall breach was 24.0% less as compared to the correctly aligned screws; 2) The mean pullout strength for the re-directed screws following end-plate breach was 23.3% less as compared to the correctly aligned screws; 3) The mean pullout strength for the pedicle screws end-plate breach was 7.6% less as compared to the correctly aligned screws. Conclusion: The pullout strength of re-directed pedicle screws after either a lateral pedicle breach or end-plate breach is significantly less than the pullout strength of correctly aligned screw. A pedicle screw that is not re-directed after end-plate breach is weaker than a pedicle screw correctly aligned, however the difference is not significant

Heliocentric Distance Dependence of Zodiacal Light Observed by Hayabusa2#

Zodiacal light (ZL) is sunlight scattered by interplanetary dust particles (IDPs) at optical wavelengths. The spatial distribution of IDPs in the Solar System may hold an important key to understanding the evolution of the Solar System and material transportation within it. The number density of IDPs can be expressed as $n(r) \sim r^{-\alpha}$, and the exponent $\alpha \sim 1.3$ was obtained by previous observations from interplanetary space by Helios 1/2 and Pioneer 10/11 in the 1970s and 1980s. However, no direct measurements of $\alpha$ based on ZL observations from interplanetary space outside Earth's orbit have been performed since then. Here, we introduce initial results for the radial profile of the ZL at optical wavelengths observed over the range 0.76-1.06 au by ONC-T aboard the Hayabusa2# mission in 2021-2022. The ZL brightness we obtained is well reproduced by a model brightness, although there is a small excess of the observed ZL brightness over the model brightness at around 0.9 au. The radial power-law index we obtained is $\alpha = 1.30 \pm 0.08$, which is consistent with previous results based on ZL observations. The dominant source of uncertainty arises from the uncertainty in estimating the diffuse Galactic light (DGL).Comment: 22 pages, 19 figures, 4 tables, accepted for publication by Earth, Planets and Spac